Method of percussion and apparatus therefor.



J. P. HICKEY.

.METHOD'OF PERCUSSION AND APPARATUS THEREFOR.

APPLICATION FILED AUG.I3. 1917.

1366,9445. PatentedMayZl, 1918. Y

WITNESS: INVENTOR. g I vBey/6711iiifiaeg ATTORNEYS.

STATES ATENT FFTQE.

JOHN P. HIGKEY, OF SAN FRANCISCO, CALIFORNIA, ASSIGN'OR 0F ONE-FOURTH TO FREDERICK W. CLAUSEN, OF SAN FRANCISCO, CALIFORNIA.

METHOD OF PERCUSSION AND APPARATUS THEREFOR.

Application filed August 13, 1917.

To all whom it may concern:

Be it known that I, J OHN P. HIoKnY, a

citizen of the United States, residing at the city and county of San Francisco and State of California, have invented new and useful Improvements in Methods of Percussion and Apparatus Therefor, of which the following is a specification.

This invention relates to an electric vibrating percussion instrument.

The object of the present invention is to provide a simple, substantial, easily operated instrument capable of producing a vibratory sound which is adapted to be used in con junction with a phonendoscope or stethoscope for percussion work outlining rapidly and definitely both physiological and pathological dullness existing in the human body under certain diseased conditions, that is, to determine the size and location of various internal organs, diseased and new growths that may be manifested by areas of dullness which may be outlined on the surface of the body by transmitting the vibratory sounds through them. Further objects will hereinafter appear.

The invention also consists of the parts and the construction and combination of parts as hereinafter more fully described and claimed, having reference to the accompanying drawings, in which- Figure l is a perspective view of the instrument.

Fig. 2 is a front view partly in section.

Referring to the drawings in detail, A indicates a handle of any suitable shape, on the outer end of which is secured a cylindrical shaped head 2. This head is hollow and is provided for the reception of an electric vibrator, generally indicated at B.

This vibrator is constructed similar to an ordinary buzzer and consists of a pair of connected magnets 3 and a buzzer 4L which makes and breaks the circuit through the coils surrounding the magnets. The vibrator as a whole is preferably rigidly secured within the head 2 and may be operated from any suitable source of current supply through a pair of wires 5 or the dry cell batteries contained within the handle A, a switch 6 of suitable construction being preferably employed to open or close the circuit through the vibrator. Suitably secured to the cylindrical casing 2 or the head is a staff Specification of Letters Patent.

Patented May 21, 1918.

Serial No. 185,878.

5. This stafi may be screwed into the casing, as shown, and may contact with the end of the magnets, as shown in Fig. 2, to permit both vibrations and the sound of the vibrator to be transmitted thereto. The casmg is also provided with a hollow pencil holder 6 and a clamping screw 7 by which the pencil 8 may be secured when inserted.

While experiencing the usual difliculty in determining splenic dullnessby finger percussion I find that by using the vibrating instrument here shown it is possible to make out the upper border of the spleen; also to determine distinctly borders over which by ordinary percussion only relative dullness would be elicited.

When the staff 5 of the vibrator was placed over an area where there is an intervening structure, as, for instance, the upper border of the spleen with the lung tissue intervening, there was noticed a shading of the vibratory note that was transmitted but the difference was, when placed outside the splenic area for comparison, sharply contrasted.

In using an electro-vibratory percussion instrument such as here shown and following the rules of ordinary percussion, it will be possible to outline rapidly and definitely both physiological and pathological dullness without annoyance from outside noises. The outlines of the organ being examined may be traced on the skin of thepatient by means of the pencil 8 as the examination is taking place.

The instrument is especially useful where many physical examinations are made at one time and where conditions are suspected wherein changes in the liver or spleen take place, and the observing of splenic and hepatic fluctuation, e. g. in typhoid fever, malaria, kala-azar, schistosomiasis, etc.

The technique is simple, as will be seen by the following description: Place the staff of a stethoscope or phonendoscope over the organ to be outlined, preferably over an intercostal space. Then, beginning at a distant point, approach the supposed position of the margin of the viscera with the staff of the vibrator. When the margin of the organ is reached there will be a distinct sound produced or a change in the faint sound that had existed. The following indicates the interspaces over which to place the staff of the stethoscope when outlining the various viscera:

Liver, 7th in the mammary line and 8th in the axillary line.

Spleen, 9th or 10th in the axillary line.

Heart, 3rd or 4th one inch to right of mammary line.

When compared with ordinary percussion the chance for error is slight, as, for instance, in outlining the spleen the dullness may be increased by a full stomach, or colon at its splenic fiexure. These sources of error will be eliminated by making the examination during fasting and after purgation.

The posterior border of splenic dullness may be continuous with that of the left kidney, but the determination of the position of an anterior and inferior border of the spleen will give sufiicient information for us to judge its size.

The mapping out of the heart and liver presents no difficulties. These organs will appear larger owing to the vibratory sound being transmitted through the areas of relative dullness.

Any stethoscope equipped with a diaphragm and a staff may be used in conjunction with the vibrator.

In making certain examinations, for instance, of the bony structure of the body and particularly the vertebrae of the spinal column, a removable tip, such as shown at 9, is preferably placed on the staff 5. The outer end of this tip is provided with a concaved recess 10 which permits the staff to be placed directly upon the spines of the vertebrae, this being also true where other bones or joints are being sounded. Other forms of tips, althoughnot here shown, may also be used and adjustment of the buzzer proper to vary the tone and rapidity of the vibrations may also be made by a screw 11 where conditions may require.

I also Wish it understood that the materials and finish of the several parts may be such as the experience and judgment of the manufacturer may dictate.

It is also to be understood that various changes in the form, proportions and minor details of construction may be resorted to within the scope of the appended claims, and that I do not wish to limit myself to the specific design and construction here shown.

' witnesses.

Having thus described my invention, what I claim and desire to secure by Letters Patent is:

l. A percussion instrument comprising a handle, a head member on the handle, an electric vibrator within the head connected with a source of current supply, a staff on the head through which the vibrations and sound of the vibrator are adapted to be transmitted, a pencil holder on the head, and means for securing a pencil therein.

2. A device for determining the size and sound responsive means having a part for engagement with and movement over the affected area, means for effecting sounding of said means, and marking means in connection with the sound responsive means and disposed so that when said part of the sound responsive means is moved out of engagement with the affected area saidmarking means is capable of being brought into engagement with the area.

4. The herein described method for determining the size and location ofinternal organs and growths and the like, which consists in setting in motion an automatically and continuously actuatedsound producing means and then in moving said means during continuous soundingthereof in contact with the affected area so as to enable the size of the organ or location of-the growth to be determined by the variations of sound emanating from said means.

In testimony whereof I have hereunto set my hand in the presence of two subscribing JOHN P. HICKEY. WVitnesses JOHN H. HERRING, W. W. HEALEY.

Copies of this patent may be obtained for five cents each, by addressing the Commissioner of Patents,

Washington, D. 0. 

